Healthcare Provider Details

I. General information

NPI: 1902426356
Provider Name (Legal Business Name): JOSEPHETTE MELINDA DOTSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4561 HIGHWAY 17 BYP S
MYRTLE BEACH SC
29577-6680
US

IV. Provider business mailing address

4561 HIGHWAY 17 BYP S
MYRTLE BEACH SC
29577-6680
US

V. Phone/Fax

Practice location:
  • Phone: 843-274-9540
  • Fax:
Mailing address:
  • Phone: 843-274-9540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7355
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: